Professional Discipline: A London (Bar) Overview

Overview

Changes in the structure of healthcare provision and regulation, advances in technology, and controversial current events have all had impacts on the world of professional discipline in 2025. Increasingly, we seem to be living through “interesting times”.

Physician Associates

Despite significant opposition from within the medical community ‒ not least the British Medical Association ‒ the Anaesthesia Associates and Physician Associates Order 2024 came into force in 2025. No doubt we will start to see cases involving these new registrants coming before the regulator soon.

Legislative Reform

The UK government’s renewed appetite for the reform of healthcare regulation is in keeping with these changes. The immediate intention is to look at the General Medical Council (GMC), the Nursing and Midwifery Council (NMC), and the Health and Care Professions Council. The reform of the remaining healthcare professional regulators is then expected to follow.

The goal behind these reforms is to make proceedings quicker and less adversarial. In anticipation of these legislative changes, the Professional Standards Authority has produced guidance to assist with how regulators amend their rules. This guidance addresses, for example, what kind of cases a regulator could properly resolve without a hearing.

Consensual disposal, as it has been previously called, has long been heralded as a goal. It has failed hitherto because of the gulf between what a regulator feels bound to require and what a registrant is disposed to accept. It remains to be seen how this gap might be bridged.

Expert Evidence

Public disquiet over the use of expert evidence has grown in recent years. The continuing debate over the safety of the conviction of Lucy Letby is a notorious example. This concern applies with force to professional regulation, in particular, where so often the decisive evidence comes down to the opinion of the expert. It is far from uncommon for expert evidence to be partial or incomplete and inadequate. At the extreme end, experts have ended up before their regulator owing to their failures to adhere to their professional responsibilities (Moodliar v General Medical Council (2025) EWHC 913 (Admin)). These concerns have led to calls for the better regulation of expert witnesses, notably from Jack Straw. It remains to be seen if the government takes up this challenge.

Artificial Intelligence

The use of AI is a major theme across all professions. The extent to which AI may enhance or indeed replace a professional’s function is subject to fierce debate with no end in sight. The duty on the professional to use AI responsibly is paramount, as demonstrated in R (Ayinde) v London Borough of Haringey (2025) EWHC 1383 (Admin), where a claimant’s legal team used fake cases generated by AI in support of its case.

The understandable reluctance of the courts to bring proceedings using the blunt instruments of contempt or perverting the course of justice leaves the focus on professional discipline as the primary sanction. Many regulators have already begun to issue guidance on this subject. However, developments in this area are so fast-moving that regulators are bound to struggle to keep up, as are we all.

Freedom of Expression

The relationship between professional regulation and freedom of expression is a fraught one and has come increasingly under the spotlight. On the one hand, the right to freedom of expression is sacrosanct and professionals should not be excluded from political debate because of fear of losing their registration. On the other hand, the courts have recognised that the reputation of a profession does impose limits on what a professional can reasonably say or do in the furtherance of a cause.

This balance has arisen in a number of different contexts. Adil v GMC (2023) EWCA Civ 1261 concerned the comments of a COVID-19 conspiracy theorist doctor. Benn v GMC (2025) EWHC 87 (Admin) considered the extent to which the reputation of the medical profession was affected by the doctor’s peaceful but illegal activism (she breached an injunction).

A number of cases have arisen in the context of the ongoing conflict in the Middle East. Chamberlain J has led the way in attempting to balance the scales on this issue ‒ for example, in Husain v SRA (2025) EWHC 1170 (Admin). Regulators face an unenviable task in deciding where to draw the line and which cases warrant referral to a hearing. Whatever decision they make is bound to attract criticism. The referral of professionals to their regulator is a weapon readily open to abuse and almost impossible to police. It does not require a crystal ball to predict that the continuing conflicts around the world, as well as increased political activism, will only lead to more such referrals in the future.

So often the question is fact-specific and it is impossible to provide definitive guidance. By way of example, as Husain noted, to compare Israel to the Nazi state may or may not amount to anti-semitism. It is one thing, of course, for these comments to be considered and analysed at a final hearing where the context can be explored and considered with care. It is another for such referrals to form the basis of an interim order application. An interim restriction of freedom of speech must surely satisfy a very high bar. Of note, in Richmond v NMC (2025) EWHC 1828 (Admin), the nurse had allegedly made a few discriminatory remarks between 2022 and 2024 and was placed on conditions of practice. When the NMC applied to extend these, the High Court was unimpressed. The public interest did not require it.

A Sobering Reminder

Regulation is a blunt instrument. In Suresh v GMC (2025) EWHC 804 (KB), the doctor in question committed suicide shortly after learning of his referral. The court rejected the suggestion that the regulator owed a duty of care to those it was investigating. Nevertheless, the stress of such a regulatory investigation is well known and must never be overlooked. We must all continue to do whatever we can to avoid such outcomes.